Breast Augmentation Revision Options After Deflation Doctor Answers, Tips
Breast Implant Revision: Q&A
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Breast Augmentation Revision Options After Deflation

I had 550 cc moderate profile saline implants done in 2005 thru the armpit. Last week I had deflation in one breast. I've been to four consultations and learned I have capsulation and that the implants never made it into the pocket, I am a 36 D and would like to be a 36 DD. I am 5'8.5 and 150 lbs. At the consultations I've been told to go up to 700, 750, 775 and 800 cc's to achieve the size I want, I have also had different opinions on going high or moderate. What will give me the desired look?

21 Doctor Answers | Asked by tex13 in Las Vegas, NV
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Breast implant revision

Your deflation is an opportunity in disguise because you can make some changes now.  First, you need a new incision, not the armpit anymore.  Second, capsules if thick need to be removed.  You might need submuscular conversion if you are above the muscle (most armpits are below the muscle though).  As for size, you should go for the "look" you want (not the cup size) by trying on sizers on your deflated side to see what implant will get closest to what you... more
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Revision choices require examination and...

Hello, When considering revision, choices require good judgment. You need to have a good "face to face" discussion with your surgeon and a good exam to determine your best alternatives. Issues such as tissue elasticity and your chest diameter will be important in predicting your best implant geometry. Guessing over the internet is not going to be much help to you here. Best Regards John Di Saia MD see video
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Revisionary Breast Surgery

Clear communication with your plastic surgeon is important in achieving the desired goals of the patient. I like to communicate with patients with “goal” pictures. During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for. Trying to predict the size of the implant preoperatively is not ideal. I think it is too much responsibility for the patient to choose the size of the implant. Ideally,... more

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Trust your instincts

You have had several consultations which is a good start. Hopefully you have a good feeling about at least one of the surgeons. Hopefully you have a few good references for the one you like. Details of implant volume and style are secondary to the skill and judgement of your chosen surgeon. Likely a moderate plus profile would be best as you are looking for more impact and the volume will likely have to be at least 650cc or more to achieve a bigger cup size.
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Breast Implant Revision and Going Bigger

First of all because the encapsulation, any revision will need an incision on the breast. It is difficult to give you an exact answer regarding implant size without actually examining you, but when you get into the 700cc+ sizes you are inviting some potential problems down the line. The implant needs to respect your breast dimensions, especially the breast width. Also because you will need a capsulectomy on the one side, this may leave your tissues thinner and make it more difficult to... more
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Breast Implant deflation and Revision

Breast augmentation through the armpit is a great way to hide scars from breast augmentation. However, in the event of deflation or revision, usually, a different approach is needed. Addtionally, I would not recommend a large implant in the range of 700cc. Large implant will give you more problems in the future. The best way to solve your problem of capsular contracture is to see a board certified Plastic surgeon experienced in doing revision breast surgery. There are now many techniques... more
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How to treat a deflated implant and capsular contracture

I would not recommend using breast implants in the 700-800cc range.  This will lead to premature sagging and atrophy (thinning) of the soft tissue of the breast.  I would recommend doing a capsulectomy (likely on both sides) which will be best performed through either a periareolar or inframammary incision-not through the armpit. You may consider converting to silicone implants also which have a lower incidence of rupture. Although you are tall and have a frame that may... more
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Breast augmentation revision

Implant deflation is a known complication of saline implants, and revision usually requires a different incision than the initial axillary one that was used to insert your implants - either an inframammary or a periareolar one. Determining the best implant size for you requires a complete physical examination, but very large implants (such as the 700+cc ones you are contemplating) are fraught with complications and long term negative effects on the tissues.
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Large breast implants will be faster to sag

Based on your photos, your deflated right breast still has a respectable amount of breast tissue and is not ptotic.  The left breast implant is positioned too high and the capsule is creating that unnatural bulge just below your collar bone.  Revision can work with a large implant, but I would also consider use of a biologic implant such as Strattice or Alloderm to help counter the inevitable sagging with gravity in the future.  The choice of moderate or high... more
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Which size should I go

Wthout actually examining you, there is really no way to determine the appropriate size that would look best for you.  I would agree that 700 cc or greater implants are probably not the best thing in the long run since they will have a much greater chance of stretching out your tissue in the long run.  If you do truly have encapsulation, you will most likely need to have the capsule addressed which is next to impossible through an axillary incision.  I would get a... more
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